Amyloid Coronary Artery Disease, Primary Systemic Amyloidosis and Paraproteinemia

A patient had primary systemic amyloidosis with severe cardiac involvement and IgG paraproteinemia. Numerous intramural coronary arteries were occluded by amyloid deposits, but arteriosclerosis of the extramural arteries was absent. The amyloid coronary artery disease was associated with angina pectoris, a myocardial infarct, and mural thrombi which resulted in cerebral, renal, pulmonic, and coronary arterial emboli.